OBJECTIVE: The purpose of this study was to evaluate the long-term
efficacy and prognosis of hysteroscopic resection and coagulation of
the base of endometrial polyps with focal atypia in fertile women with
or without progestin suppression.
STUDY DESIGN: We conducted a quasi-randomized trial in which conservative
treatment was offered to 21 patients who had endometrial
polyps with focal atypia and a surrounding normal endometrium. The
polyps were analyzed separately from their bases. Random biopsy
specimens were taken from 4 standard places of the endometrium.
RESULTS: Eighteen women (10 women with an intrauterine device and
8 women with no intrauterine device) completed the follow-up procedure.
After 5 years, we found no difference in the 2 groups regarding
recurrence of atypical polyps.
CONCLUSION: Conservative resectoscopic treatment may be considered
in fertile women with atypical polyps if polyp base and surrounding
endometrium are benign. If women want to become pregnant at
short term, the use of progestins can be delayed, with a strict follow-up
procedure. Larger studies should be encouraged.
